NHS Report Proposes Overhaul To Deal With Funding Shortfall

London's hospital services are facing a huge shake-up following a report from NHS England.

The report, London – A Call to Action, says it wants to stimulate "an open and honest debate with the public, health and care professionals and other stakeholders" about the way healthcare in the capital is changing. What this actually means is centralising some services and cutting services in other places. Why? London is facing a £4bn NHS funding shortfall between 2015-2020.

The report has a big focus on the changing healthcare needs of Londoners; we're ageing, we're getting fatter and developing longer-term, chronic illnesses. Although as a city we live longer than much of the rest of England, life expectancy within London varies greatly as a result of inequality. The NHS wants a big push on preventative measures, lifestyle choices and keeping people out of hospitals in the first place, which we agree with – a healthier population is a good thing.

Then we come to finances. NHS funding is expected to be flat in real terms for the next decade, but there's a predicted 4% growth in healthcare demand generally (10% for specialised services). The report describes the savings this requires as "unprecedented" and concludes the only way to do it is to "fundamentally redesign care to meet the needs of patients". That's closures, to you and me.

Pre-release coverage focused on London's hospitals being 'at breaking point'. But while London's health services may be performing badly on patient satisfaction when it comes to clinical standards, we're doing pretty well (in the review set up in the wake of the Mid Staffordshire scandal, London was the only region with no hospitals with concerning mortality figures). London hospitals are already implementing changes that are supposed to iron out differences in care at weekends (though the Save Lewisham Hospital campaign points out the figures that say more people die at weekends because of staffing may be flawed).

Krishnan Guru-Murthy recently had one of the report's authors into Channel 4 News and made the point that though the report might not outright say closures, that's what it means.

Ross Lydall in the Evening Standard has been gathering criticism from across the capital, highlighting that huge sums of money are leaking from the NHS because of PFI payments (thanks, Gordon Brown) and escalating running costs which, says Dr Tony O'Sullivan of Lewisham Hospital, are because of the increasing privatisation within the NHS. Opponents of the plan agree London's hospitals are under increasing strain, but say that alternative provision has to be in place before cuts of this kind can be proposed.